Icahn School of Medicine at Mount Sinai, New York, New York.
JACC Cardiovasc Imaging. 2015 May;8(5):579-596. doi: 10.1016/j.jcmg.2015.02.006.
Coronary artery calcium scanning (CAC) has emerged as the most robust predictor of coronary events in the asymptomatic primary prevention population, particularly in the intermediate-risk cohort. Every study has demonstrated its superiority to risk factor-based paradigms, e.g., the Framingham Risk Score, with outcome-based net reclassification indexes ranging from 52.0% to 65.6% in the intermediate-risk, 34.0% to 35.8% in the high-risk, and 11.6% to 15.0% in the low-risk cohorts. CAC improves medication and lifestyle adherence and is cost-effective in specified populations, with the ability to effectively stratify the number needed to treat and scan for different therapeutic strategies and patient cohorts. Data have emerged clearly demonstrating the worse prognosis associated with increasing CAC on serial scans, suggesting a potential role for evaluating residual risk and treatment success or failure. CAC is also strongly associated with the development of stroke and congestive heart failure.
冠状动脉钙扫描（CAC）已成为无症状一级预防人群中预测冠状动脉事件最有力的指标，特别是在中危人群中。每一项研究都表明，它优于基于危险因素的模式，例如弗雷明汉风险评分，在中危人群中，基于结局的净重新分类指数范围为 52.0%至 65.6%，高危人群中为 34.0%至 35.8%，低危人群中为 11.6%至 15.0%。CAC 可改善药物和生活方式的依从性，在特定人群中具有成本效益，能够有效分层不同治疗策略和患者人群所需的治疗和扫描数量。越来越多的数据清楚地表明，在连续扫描中 CAC 增加与预后恶化相关，这提示 CAC 可能有助于评估残余风险和治疗成功或失败。CAC 还与中风和充血性心力衰竭的发生密切相关。
